springer us jun 1988 (2 Ergebnisse)

Buch. Zustand: Neu. Neuware - Although some investigators have questioned the importance and even the existence of silent myocardial ischemia, documentation presented at this two day symposium leaves little doubt about its existence and importance. It has been estimated that about 3 million of the estimated 4 million angina sufferers in the United states have frequent episodes of silent myocardial ischemia. Although it is not possible to define how many Americans die due to silent ischemia, it has been suggested that the mortality rate may exceed hundreds of thousands of victims annually. Unfortunately, there still remains a lack of definitive information as to why some ischemic events are painless. Some suggest the concept that the location and size of the myocardium at jeopardy relates to pain, that the pain threshold varies from patient to patient or that there are neurological deficits in the myocardium of some patients with silent ischemia. Abnormalities in myocardial perfusion and function can occur without pain. An interesting observation presented by several investigators has been that when a coronary artery is occluded in man, no ischemic pain is perceived for the first 30 seconds. Only after a 30 second period or so of occlusion does angina occur. An even more confusing observation is that some 30 second periods of occlusion of the same vessel in the same patient results in angina while the next occlusion can be a totally silent event.

Buch. Zustand: Neu. Neuware - Environmental permits enable regulatory agencies to control the disturbance and degradation of the environment caused by man's activities. Created by governments through legislation, the permit processes are administered by elected officials. Environmental legislation is relatively new as an independent field of the law: the laws themselves are primarily a conglomeration of older legal doctrines from other fields of law, modified and adapted for particular situations (Landau and Rheingold 1971). Like other laws, environmental laws are meant to serve and protect the rights and well-being of the public. However, like other laws, they have created confusion, a proliferation of costly paperwork, and some inequities. Numerous statutes, dealing with most aspects of pollution, exist at every level of government-so many, in fact, that they frequently conflict and overlap. These statutes establish a public policy toward polluters. They also empower the regulatory bodies that issue permits. It would be impossible to compile a list of requirements for each type of permit. Therefore, this book will acquaint the reader with the common aspects of environmental permits: their terminology, components, and application processes. This book covers the permit process from initial agencies/applicant contacts through application parts and procedures, to application approval. Special emphasis has been placed on bringing together copies of laws and lists of agencies as appendices. The appendices give the reader easy access to materials that will help clarify the permit process.